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General NPI Number Information
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NPI Number | 1083331417
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Entity Type | Organization
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Legal Business Name | RK, ADC, LLC
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 4936 BROWNSBORO ROAD
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City | LOUISVILLE
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State | KY
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Zip | 40222
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Country | US
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Telephone | 502-365-2586
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Fax |
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Provider Business Mailing Address
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Address Line | 4940 HAZELWOOD AVENUE SUITE 102
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City | LOUISVILLE
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State | KY
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Zip | 40214-1270
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Country | US
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Telephone | 502-819-1297
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/ADMINISTRATOR
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Name | EDWARD JOSEPH MINNIS
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Credential |
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Telephone | 502-365-2586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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